Operative interventions for extrahepatic portomesenteric venous aneurysms and long-term outcomes

Annals of Vascular Surgery
Mark D FlemingThomas C Bower

Abstract

Extrahepatic portal venous aneurysms (PVAs) are rare, and the pathogenesis is not fully understood. The optimum management of these patients is unknown. Consecutive patients with PVA were identified over an 18-year period (1992-2010). A retrospective review was conducted. Clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. Four patients were identified who underwent surgical management of an extrahepatic PVA. Operative technique using left renal vein, femoral vein panel graft, polytetrafluoroethylene (ePTFE) graft, and segmental aneurysm wall resected with aneurysmorrhaphy is described. Early complications occurred in 1 patient with an ePTFE graft. The patient returned to the operating room for bleeding. In addition, the same patient had a late graft thrombosis 6 years postoperatively when the anticoagulation was discontinued for pregnancy. The remainder of the patients recovered without complication, and their repairs are still patent with a mean follow-up of 78 months (17-144 months). There were no mortalities in the series. Operative intervention for portomesenteric venous aneurysm can be done safely in select patients and should be considered in those...Continue Reading

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Citations

Jun 21, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ola AhmedAdeel S Khan

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